title: [Neurological symptoms in children with intussusception].
abstract: BACKGROUND
  Intussusception is a potentially severe obstructive disease that occurs when a more proximal portion of bowel invaginates into a more distal part of the bowel. Patients with intussusception often present with a wide range of non-specific systemic symptoms, with less than one quarter presenting with the classic triad of vomiting, abdominal pain, and bloody stools. An acute change in level of consciousness could be the only clinical symptom of this disorder.
  
  
  OBJECTIVE
  To ascertain the frequency and nature of the neurological symptoms in children with intussusception, and to describe the characteristics of the patients presenting in this atypical way.
  
  
  METHODS
  We retrospectively reviewed the records of 351 children presenting with intussusception from 2000 to 2012. General epidemiological data, abdominal and neurological signs and symptoms, duration of symptoms and effectiveness of treatment, were analysed in all patients.
  
  
  RESULTS
  Of the 351 patients studied, 15 (4.27%) had one or more neurological symptoms recorded at presentation, with lethargy being the most frequent (66.66%), followed by hypotonia, generalized weakness, paroxysmal events, and fluctuating consciousness. Sixty per cent of these fifteen patients showed isolated neurological symptomatology, and eleven of them (73.3%) needed a laparotomy to reduce the intussusception.
  
  
  CONCLUSIONS
  Intussusception should be considered in the differential diagnosis in infants and young children presenting as a pediatric emergency with lethargy, hypotonia, generalized weakness, paroxysmal events and/or sudden changes in consciousness, even in the absence of the classical symptoms of intussusception. An early recognition of intussusception may improve the global prognosis and avoid ischaemic intestinal sequelae.
authors.affiliation: Sección de Neurología Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España. Electronic address: janadominguezcarral@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Domínguez-Carral
authors.affiliation: Sección de Neurología Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España.
authors.forename: V
authors.initials: V
authors.lastname: Puertas-Martín
authors.affiliation: Sección de Neurología Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España.
authors.forename: I
authors.initials: I
authors.lastname: Carreras-Sáez
authors.affiliation: Sección de Neurología Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España.
authors.forename: A I
authors.initials: AI
authors.lastname: Maraña-Pérez
authors.affiliation: Sección de Neurología Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España.
authors.forename: T
authors.initials: T
authors.lastname: Escobar-Delgado
authors.affiliation: Sección de Neurología Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España.
authors.forename: J J
authors.initials: JJ
authors.lastname: García-Peñas
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000150:complications*; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies
keywords: Acute encephalopathy; Alteración del nivel de consciencia; Altered consciousness; Encefalopatía aguda; Intussusception; Invaginación intestinal; Manifestaciones neurológicas; Neurological symptoms